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The Centers for Medicare and Medicaid Services (CMS) has launched a Fraud, Waste and Abuse (FWA) training and education module that is available through the CMS Medicare Learning Network (MLN) website at www.cms.gov/MLNProducts. Independent practice associations (IPAs) or medical groups should use this training module to satisfy the training requirement for their administrative staff.
Most of Health Net's contracting providers (or first-tier, downstream and related entities (FDRs)) are deemed to have met the FWA training and education requirements due to their enrollment into Medicare Parts A or B, or through accreditation as a supplier of durable medical equipment, prosthetics, orthotics, and supplies (DMEPOS) or through the Joint Commission on Accreditation of Healthcare Organizations (JCAHO). Therefore, this communication is directed to IPAs or medical groups regarding coordination of FWA training for their employees only. The IPAs or medical groups employees who are involved in the administration or delivery of Parts C and D benefits must, at a minimum, receive FWA training within 90 days of initial hiring and annually thereafter. According to CMS, this includes employees who interact with Medicare beneficiaries, orally or in writing, or those who have contact with beneficiary information, such as claims, letters and medical records.
IPAs or medical groups are accountable for maintaining records for a period of 10 years of the time, attendance, topic, certificates of completion (if applicable), and test scores of any tests administered to their employees related to FWA training. This is subject to audit upon request from Health Net or CMS.
If you have any questions regarding the Medicare Part C and D Fraud, Waste and Abuse Training, refer to the CMS website at www.cms.gov/Regulations-and-Guidance/Guidance/Manuals/Downloads/mc86c21.pdf > Section 50.3.2. For all other questions, contact the Health Net Provider Services Center by email through the Health Net provider Web site, or by telephone at 1-888-445-8913.